The Social Health Authority (SHA) has issued a warning to all healthcare facilities, reminding them that emergency medical treatment must be provided without discrimination or financial barriers.
In a statement on Saturday, August 1, SHA CEO Mercy Mwangangi reiterated that the right to emergency medical treatment is protected under the Constitution.
She added that contracted facilities are legally and contractually required to provide emergency treatment immediately, regardless of a patient's financial circumstances.
"The Social Health Authority (SHA) reminds all contracted Health Care Providers that the right to emergency medical treatment is guaranteed under Article 43(2) of the Constitution of Kenya.
"In addition, every SHA-contracted provider is contractually obligated to provide mandatory emergency services and shall not refuse, delay or withhold emergency treatment on account of a patient's inability to pay or for any other financial reason," the statement read.
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According to SHA, patients requiring emergency treatment must not be denied, delayed, referred or transferred solely because they cannot pay, have no confirmed health insurance benefits, or are unable to provide a deposit, advance payment or financial guarantee.
The authority explained that the Emergency, Critical and Chronic Illness Fund (ECCIF) will finance eligible emergency treatment during the first 24 hours.
After that period, eligible healthcare services will be covered through the Social Health Insurance Fund (SHIF) or any other applicable payment arrangement.
Where a health facility lacks the capacity to continue managing a patient, it must first stabilise the patient before referring them to an appropriate contracted facility in line with the Ministry of Health Referral Guidelines and the SHA contract.
SHA warned that providers who disregard these requirements will face strict enforcement measures, including possible termination of their contracts.
"Any provider found to have engaged in such conduct shall be liable to de-empanelment and other contract enforcement measures, including termination of the SHA Contract, without prejudice to any action that may be taken by the relevant regulatory or enforcement authorities," the statement added.
SHA also directed the leadership of all contracted health facilities to ensure that the notice is communicated to relevant staff and implemented without delay.
"All Chief Executive Officers, Medical Superintendents, Facility Administrators and Emergency Department staff are required to bring this notice to the attention of all clinical, admissions and finance personnel and to ensure immediate compliance," the statement concluded.
Elsewhere, SHA has issued a notice reminding non-salaried households across the country to register for the national health insurance scheme.
In an update earlier Saturday, the authority said registration enables individuals and their families to access healthcare services at SHA-accredited facilities nationwide.
"Every Kenyan has the right to affordable, quality healthcare. Under the Social Health Insurance Act, 2023 and its Regulations, 2024, all residents, including farmers, traders, boda boda riders, casual workers, domestic workers and the self-employed, are required to register with the Social Health Authority (SHA)," the notice read.
According to SHA, non-salaried households can register through several platforms, including by dialing *147# on a mobile phone, visiting the SHA or Afya Yangu websites, or visiting any SHA branch office or Huduma Centre.
Applicants are required to create an account using their National ID number and a phone number registered in their name before setting a confidential PIN.
SHA said applicants should confirm that their personal information matches their identification documents before adding eligible dependants, including spouses and children where applicable.
They are also required to complete a means testing process by providing accurate details about their income, household and assets to determine the amount they will contribute.
After assessment, SHA will notify members of their monthly or annual contribution.
Members can either pay the annual contribution in full or opt for the Lipa Pole Pole payment plan, which allows instalment payments.
Under the arrangement, healthcare cover becomes active once payments equivalent to four months of the annual contribution have been made.
Payments can also be made through Paybill number 200222 using the member's National ID number as the account number.
Once the required payment has been made, members can activate their healthcare cover and access services by presenting their National ID at any SHA-accredited healthcare facility across the country.
